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      Macular choroidal thickness in normal Egyptians measured by swept source optical coherence tomography

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          Abstract

          Background

          To provide a normal database of choroidal thickness (CT) in nine Early Treatment Diabetes Retinopathy Study (ETDRS) subfields in Egypt using deep-range imaging swept source optical coherence tomography (DRI SS OCT).

          Methods

          This study included a total of 129 eyes of 71 normal Egyptian subjects, comprising 63 males and 66 females. The mean age was 36.85 ± 14.22 years (range, 16–67 years). The mean axial length was 23.84 ± 0.78 mm. CT was measured in nine subfields as defined by the ETDRS-style grid using a DRI SS OCT, and line measurements of subfoveal choroidal thicknesses (SFCT) were also performed.

          Results

          Mean SFCT was 300.87 ± 72.256 μm for ring measurements and 319.72 ± 76.45 μm for line measurements ( P = 0.04). CT was higher in the superior and temporal quadrants than the inferior and nasal quadrants. A negative correlation between subfoveal choroidal thickness and age was detected in all regions ( P < 0.001) except the nasal quadrant. A negative correlation between the SFCT and axial length was also detected ( P < 0.001). Males tended to have a thicker choroid than females; however, the difference was not significant.

          Conclusions

          DRI SS OCT provides a topographic map of choroidal thickness with an ETDRS layout. This study establishes, for the first time, a normal database for CT in the Egyptian population. Age and axial length were associated with choroidal parameters in healthy subjects. Line measurements of the SFCT differed significantly from SFCT ring measurements, so it is recommended that each method be compared independently.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12886-016-0314-1) contains supplementary material, which is available to authorized users.

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          Most cited references20

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          A pilot study of enhanced depth imaging optical coherence tomography of the choroid in normal eyes.

          To measure macular choroidal thickness in normal eyes at different points using enhanced depth imaging (EDI) optical coherence tomography (OCT) and to evaluate the association of choroidal thickness and age. Retrospective, observational case series. EDI OCT images were obtained in patients without significant retinal or choroidal pathologic features. The images were obtained by positioning a spectral-domain OCT device close enough to the eye to acquire an inverted image. Seven sections were obtained within a 5 x 30-degree area centered at the fovea, with 100 scans averaged for each section. The choroid was measured from the outer border of the retinal pigment epithelium to the inner scleral border at 500-microm intervals of a horizontal section from 3 mm temporal to the fovea to 3 mm nasal to the fovea. Statistical analysis was performed to evaluate variations of choroidal thickness at each location and to correlate choroidal thickness and patient age. The mean age of the 30 patients (54 eyes) was 50.4 years (range, 19 to 85 years), and 14 patients (46.7%) were female. The choroid was thickest underneath the fovea (mean, 287 microm; standard deviation, +/- 76 microm). Choroidal thickness decreased rapidly in the nasal direction and averaged 145 microm (+/- 57 microm) at 3 mm nasal to the fovea. Increasing age was correlated significantly with decreasing choroidal thickness at all points measured. Regression analysis suggested that the subfoveal choroidal thickness decreased by 15.6 microm for each decade of life. Choroidal thickness seems to vary topographically within the posterior pole. The thickness of the choroid showed a negative correlation with age. The decrease in the thickness of the choroid may play a role in the pathophysiologic features of various age-related ocular conditions.
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            Diurnal variation of choroidal thickness in normal, healthy subjects measured by spectral domain optical coherence tomography.

            To describe the pattern and magnitude of diurnal variation of choroidal thickness (CT), its relation to systemic and ocular factors, and to determine the intervisit reproducibility of diurnal patterns. A prospective study was conducted on 12 healthy volunteers who each underwent sequential ocular imaging on two separate days at five fixed, 2-hour time intervals. Spectral domain optical coherence tomography (OCT) with enhanced depth imaging and image tracking was performed using a standardized protocol. Choroidal and retinal thicknesses were independently assessed by two masked graders. CT diurnal variation was assessed using repeated-measures ANOVA. A significant diurnal variation in CT was observed, with mean maximum CT of 372.2 μm, minimum of 340.6 μm (P < 0.001), and mean diurnal amplitude of 33.7 μm. Retinal thickness (mean, 235.0 μm) did not exhibit significant diurnal variation (P = 0.621). The amplitude of CT variation was significantly greater for subjects with thicker morning baseline CT compared with those with thin choroids (43.1 vs. 10.5 μm, P < 0.001). There were significant correlations between amplitude of CT and age (P = 0.032), axial length (P < 0.001), and spherical equivalent (P < 0.001). The change in CT also correlated with change in systolic blood pressure (P = 0.031). Comparing CT on two different days, a similar diurnal pattern was observed, with no significant difference between corresponding measurements at the same time points (P = 0.180). There is significant diurnal variation of CT, with good intervisit reproducibility of diurnal patterns on two different days. The amplitude of variation varies with morning baseline CT, and is correlated with age, axial length, refractive error, and change in systolic blood pressure.
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              Choroidal thickness in normal eyes measured using Cirrus HD optical coherence tomography.

              To examine choroidal thickness and area in healthy eyes using spectral-domain optical coherence tomography (SD-OCT). Retrospective, observational case series. Thirty-four eyes (34 subjects), with no retinal or choroidal disease, underwent high-definition raster scanning using SD-OCT with frame enhancement software. Choroidal thickness was measured from the posterior edge of the retinal pigment epithelium to the choroid/sclera junction at 500-microm intervals up to 2500 microm temporal and nasal to the fovea. The central 1-mm area of the choroid was also measured, along with foveal thickness of the retina. All measurements were performed by 2 independent observers. Statistical analysis was used to correlate inter-observer findings, choroidal thickness and area measurements with age, and choroidal thickness with retinal foveal thickness. The 34 subjects had a mean age of 51.1 years. Reliable measurements of choroidal thickness were obtainable in 74% of eyes examined. Choroidal thickness and area measurements had strong inter-observer correlation (r = 0.92, P < .0001 and r = 0.93, P < .0001 respectively). Area had a moderate negative correlation with age (r = -0.62, P < .0001) that was comparable to the correlation between mean subfoveal choroidal thickness and age (r = -0.61, P < .0001). Retinal and choroidal thickness were found to be poorly correlated (r = -0.23, P = .18). Mean choroidal thickness showed a pattern of thinnest choroid nasally, thickening in the subfoveal region, and then thinning again temporally. Mean subfoveal choroidal thickness was found to be 272 microm (SD, +/- 81 microm). Choroidal thickness can be measured using SD-OCT high-definition raster scans in the majority of eyes. Choroidal thickness across the macula demonstrates a thin choroid nasally, thickest subfoveally, and again thinner temporally, and a trend toward decreasing choroidal thickness with age. Copyright (c) 2010 Elsevier Inc. All rights reserved.
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                Author and article information

                Contributors
                magdymoussa60@gmail.com
                daliasabry73@yahoo.com
                00201065566530 , waelsoliman73@yahoo.com
                Journal
                BMC Ophthalmol
                BMC Ophthalmol
                BMC Ophthalmology
                BioMed Central (London )
                1471-2415
                5 August 2016
                5 August 2016
                2016
                : 16
                : 138
                Affiliations
                [1 ]Ophthalmology Department, Tanta University, Tanta, Egypt
                [2 ]Mansoura Ophthalmic Center, Mansoura, Egypt
                [3 ]Ophthalmology Department, Assiut University Hospitals, Assiut, Egypt
                Author information
                http://orcid.org/0000-0002-3548-8267
                Article
                314
                10.1186/s12886-016-0314-1
                4974688
                27496132
                f5368fd1-3eb6-44bf-b366-006ed84803da
                © The Author(s). 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 10 March 2016
                : 27 July 2016
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2016

                Ophthalmology & Optometry
                choroidal thickness,deep-range imaging swept source,oct,egypt
                Ophthalmology & Optometry
                choroidal thickness, deep-range imaging swept source, oct, egypt

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